How old were you when your parent(s) died?
Mother Father

(eg. I was 15 when my mother died and 4 when my father died)

How did they die?

How did your world change?


After your parent(s) died, did anyone say anything that hurt your feelings
or you wish they did not say? If yes, what did they say and why did you not like it?


What could they have said instead, and why?


Did you feel that others were uncomfortable around you?
If so, what did they do to make you feel that way?


Did you have anyone say something that was hurtful and you
wish they knew better?

If you could give a tip to a child who had their mom or dad die,
what would it be ?

If you could share words of wisdom to an adult who will now have to
care for a child that had parent(s) die, what would you say?

Is there anything else you would like to share with us?

Tell us about yourself, what is your occupation?
Did your parent's death impact your choice of occupations in any way?

Did you attend college? If no, please enter "no" and skip to next question.
If yes, where? What degree(s) did you earn? How was your college paid for?

Is there anything else you would like to say?

Optional, but desired, information:

Name:

Current Age:

Address and phone number (with area code):

Parent(s) Name:


Thank you for your time and insight. Once our "tip sheet" is created it will be accessible on this website.